Sp.erm DNA fragmentation: what's next

For Q&A #2
Mrs. Katia asked: I'm wondering, though, if you ever re-checked Mr. Hammer's sperm fragmentation after a few months on the supplements? We might have the same problem here, and my husband is on pretty much the same stuff! I was excited to see that. However, we aren't going to send in his sperm before trying again. I'm just curious if you know there was a difference in the dna integrity or if you're hoping like we are. Thanks!

Excellent question and one we’ve been debating about for a few months now. Prior to our cancelled IVF cycle #3 we were set on not checking. The reason was because the decision would not change if we were doing IVF or not. But now that we’ve had a chemical pregnancy via IVF to IUI conversion we’ve become more curious about whether all these supplements have been effective. We’ve never had ANYTHING happen with our 5 other IUI’s. And we have time to get it checked prior to IVF #4. Being faced with the very real possibility that IVF will not work for us has made us wonder now, with supplementation, if we could ever get pregnant on our own. And the chemical pregnancy has given us some hope – crazy huh? Will that stop us from IVF #4? Nope. But if we have to move on to adoption it’s not like we’re going to stop trying on our own. The question then comes, do we stop the supplements? If they work, then the answer is no. But how will we know if we haven’t tested! And that is why we are now thinking it might be worth another check. Plus we’re currently on my insurance which will pay for 60% of the cost. Not too shabby when you consider that almost everything else is out of pocket.

So it’s very possible that in August we might be retesting Hammer’s DNA fragmentation. For those of you reading that are thinking, “What on earth is she talking about?” Don’t feel in the dark! This is a very rarely tested sperm analysis. We only got it tested because we kept getting gorgeous day three embryos to transfer that would end up in BFN or miscarriage. Typically the egg DNA drives the first three days of cell division, after that the sperm DNA kicks in and if it’s no good then there is no baby. Here is an excerpt from an article in RESOLVE about SCSA (the DNA test):

• "Sperm DNA fragmentation has little or nothing to do with the parameters that we measure on the routine semen analysis. It has little to do with the shape of the sperm or whether the sperm are moving. It is a completely independent variable. Men with otherwise normal semen analyses can have a high degree of DNA damage and men with what was called very poor sperm quality can have very little DNA damage. More importantly what has also been demonstrated is that the degree of DNA fragmentation correlates very highly with the inability of the sperm to initiate a birth regardless of the technology used to fertilize the egg such as insemination, IVF or ICSI. Sperm with high DNA fragmentation may fertilize an egg and embryo development stops before implantation or may even initiate a pregnancy but there is a significantly higher likelihood that it will result in miscarriage. By testing for sperm DNA fragmentation, many cases of formally “unexplained” infertility can now be explained. Many of those couples who have been previously unable to conceive with what would be considered extreme measures have been diagnosed with high sperm DNA fragmentation and treated. It is now very clear to see that having this information about the quality of the sperm can be tremendously helpful to couples and their physicians."

Hammer’s family has a history of infertility on his father’s side so when everything looked good but left us empty handed we pushed for this test and TAH-DA! 48% fragmentation, which is really, really bad.

<15% normal
15-30% good to fair = IUI or IVF for higher % in the range
>30% poor = IVF w/ICSI

If you want to read more about it, Conceive This!, wrote a really great post about it. And then there is also this website where I took the excerpt from, that provides another explanation.

So what causes it?

• "The causes of high DNA fragmentation are those same causes of male factor infertility that we have known about for years such as chemical/toxin exposure, heat exposure, varicocele, infection, age, smoking, testicular cancer, radiation, and anything that increases the free radical levels in the semen among a list of many other things. It is very important to understand that sperm DNA fragmentation can change with time and it can be improved in many cases. The goal of a male factor evaluation is to seek out the causes of poor sperm quality and try to correct them so conception can occur naturally or to improve the sperm quality for IVF and maximize the chances of success."

How we have been treating the problem: (Hammer’s Supplements)

-Vitamin C 1000 mg (500 mg morning and evening)
-Vitamin E 800 IU (400 IU morning and evening)
-L Acetyl-Carnitine 1 gram
-L Carnitine 1 gram (morning and evening)
-Pycnogenol 100 mg
-Co Q-10 75 mg
-Centrum’s One-a-Day Men’s Health

In addition to vitamins we are both drinking antioxidant smoothies:

1 oz acai juice
1 oz pomegranate juice
1 oz frozen wheat grass
½ cup organic blueberries
½ cup organic orange and/or pineapple juice
½ cup organic yogurt
2 tbsp raw honey

I will say that, for myself, after 6 months of drinking these smoothies, plus a multivitamin and 100 mg Pycnogenol I went from having questionable antral follicles on my left ovary to having excellent numbers on both sides with my left better than my right! So if it worked for me I really hope it worked for Hammer.

*As before if you have any other questions for me just leave them in the comments and I will do a post about them.